Biomedical subjects
Publications and source records attributed to M Nowakowski.
The authors presents use of the minitracheotomy as a method of the restoring of airways during occlusion of the larynx in emergency cases. Minitracheotomy is a simple method of the restoring of airways by small endotracheal tube.
We evaluated a new analyzer designed for point-of-care testing of blood gases, sodium, potassium, ionized calcium, and hematocrit. The Gem Premier (Mallinckrodt) system has two components: the analyzer and a disposable cartridge. Analysis takes place in the cartridge, which contains the electrochemical sensors, the calibrants, the reagents, the sampling stylus, and the waste container. The system was evaluated for imprecision and accuracy. With aqueous control materials, total imprecision (CV) was: pH, 0.10-0.18%; PCO2, 3.16-5.78%; PO2, 2.92-4.85%; sodium, 0.82-1.44%; potassium, 1.35-1.48%; ionized calcium, 0.75-1.45%; and hematocrit, 1.13-1.83%. Accuracy of the system was assessed by split-sample comparison with the Radiometer ABL 330 blood gas analyzer for pH and blood gases, the Nova Stat Profile 5 for whole-blood electrolyte and hematocrit analysis, and the IL Phoenix for plasma electrolyte analysis. After outlier correction, regression statistics were excellent for all analytes except sodium, which demonstrated Sy[x values between 1.80 and 2.30 mmol/L and 0.85 < or = r < 0.90.
Pneumonia due to Chlamydia trachomatis is a disease limited mainly to infants under 6 months of age. Rare cases have been reported in immunocompromised adults. One possible reason for the propensity of the pneumonia to occur in the very young may be related to differences in the phagocytic and bactericidal capacity of alveolar macrophages (AMs) in young infants and adults. At birth a function of AMs is clearance of surfactant-related material from the alveolar surface. Studies in animals have suggested that engorgement of AMs with surfactant-related lipids may reduce the microbicidal capacity of these cells. In the present study we determined that AMs obtained from healthy, nonsmoking adults were capable of killing both human biovars of C. trachomatis, with complete killing observed by 48 h after inoculation. Preincubation of AMs from adults with surfactant did not reduce the capacity of the cells to kill C. trachomatis.
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Graft-vs.-host (GVH) reactivity of parental lymph node (LN) cells was assayed by measurements of 3H-thymidine incorporation in vivo in spleens of irradiated F1 recipients. Preincubation of parental LN cells with vesicular stomatitis virus (VSV) for 2 h at 37 degrees C followed by washing resulted in an 85-90% reduction in splenic radioactivity, as did injection of VSV on days 0-2 after recipients received untreated parental LN cells. In contrast, 3H-thymidine incorporation in the spleens or irradiated F1 hosts was not affected by VSV when F1 bone marrow cells were incubated with the virus. In addition, preincubation of F1 B cells with VSV still allowed these syngeneic B cells to be recruited into proliferation by mitomycin-treated parental LN cells. The inhibitory effect of VSV, thus, seems to be specific for T-cell proliferation. These observations suggest that viral immunosuppression might be capable of being developed into a useful strategy for selective deletion of lymphocytes capable of reacting against histocompatibility antigens and initiating GVH reactions.
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A variety of lymphoid cell populations were examined in terms of their ability to replicate vesicular stomatitis virus (VSV), a lytic, RNA-containing virus maturing at the cell surface. The number of cells capable of producing VSV was estimated in terms of infectious centers by the virus plaque assay (VPA), and morphologically by electron microscopy (EM). The lymphoid cells examined in this study included: (a) lymph node cells from delayed hypersensitive guinea pigs stimulated by specific antigen, (b) mouse spleen cells activated by selective bone marrow-derived (B) cell and thymus derived (T) cell mitogens, and (c) cells of human and murine continuous lymphoblastoid or lymphoma lines. In unstimulated cultures of guinea pig lymph node cells there is a background of approximately 1 in 1,000 cells which produces VSV; in purified protein derivative (PPD)-stimulated cultures the number of cells producing virus was 1.6% in the VPA and 1.9% by EM. These cells were large lymphocytes with some morphological features of transformed lymphocytes but were not typical blast cells. A few macrophages were associated with virus in both stimulated and control cultures. These observations indicate that (a) cells responsive to antigens, as detected by a marker virus, were lymphocytes; (b) cells other than lymphocytes (macrophages) were capable of replicating VSV even without antigenic stimulation; and (c) the correlation of results obtained by VPA and morphologic examination was usually quite good. Of the total number of mouse spleen cells stimulated with concanavalin (Con A), a T cell mitogen, 4.5 (EM)-5.7% (VPA) were associated with VSV. These were characteristic transformed lymphocytes, similar to phytohemagglutinin (PHA)-stimulated human lymphocytes. In contrast Escherichia coli lipopolysaccharide (LPS)-treated mouse spleen cultures contained lower numbers of virus plaque-forming cells. The majority of such cells associated with virus displayed extensive rough endoplasmic reticulum. Two cultured murine lymphomas containing lymphocytes with the theta surface marker (L5178Y and EL-4) showed a 15-100-fold higher incidence of virus-producing cells than leukemias (L1210 and C57Bl/6) which did not carry this marker. Similarly, the L2C guinea pig leukemia, a known B cell leukemia, yielded a low percent of virus plaque-forming cells (<2%). However, MOPC-104, a plasma cell tumor presumed to be of B cell origin, was found to be an efficient virus producer. There was a wide variation in the efficiency of VSV replication among human lymphoblastoid lines. One line, Wil-2, produced 80% infectious centers after 24 h of exposure to VSV, and all cells were associated with virus at the EM level. The relationship between the virus-producing cells and different lymphocyte subpopulations as well as the efficiency of the two assays for studying virus-producing lymphocytes is discussed.
Replication of vesicular stomatitis virus (VSV) is restricted in one human lymphoblastoid cell line (Raji), but not in another similar cell line (Wil-2), compared with growth in HeLa cells. This restriction is characterized by a low proportion of cells yielding infectious virus and is associated with limited production of 42S virion RNA. Primary transcription of 13S and 26S VSV-specific RNA is not restricted in Raji cells, and the 13S RNA produced contains adenylate-rich sequences. This suggests that the block in Raji cells involves some step required for the replication of virion RNA.
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A glycan extracted from Coriolus versicolor (PSK, Krestin) which has antitumor and immunomodulator properties produced marked morphological and biochemical changes when added to cultures of mouse peritoneal macrophages. The cells were more spread and elongated than in control cultures, and these changes were accompanied by alterations in the rate of protein and DNA synthesis. In PSK-treated murine peritoneal macrophages the rate of protein synthesis increased above the level seen in control cultures after two days and reached a level twenty-fold higher than control on day four; this elevated rate of protein synthesis was maintained throughout the seven-day observation period. DNA synthesis was induced after four days in the presence of PSK, and reached a level ten-fold higher than control baseline on day five. This induction of DNA synthesis, however, could not be attributed to a mitogenic activity on lymphocytes. The alterations caused by PSK in macrophage metabolism may be related to the immunomodulating and antitumor activities of PSK in vivo.
Pulmonary immunity has not been studied in children with acquired immunodeficiency syndrome (AIDS) or tuberculosis (TB), even though lungs of both children and adults infected with human immunodeficiency virus (HIV-1) or Mycobacterium tuberculosis are affected frequently and severely. In the present studies, the distributions of T (CD3+, CD4+, CD8+) and B (CD19+) lymphocytes in bronchoalveolar lavage fluid (BALF) and blood of children with AIDS (N = 28) and children with pulmonary TB (N = 18) were determined using direct immunofluorescence (flow microfluorimetry). The distributions of lymphocyte subsets in BALF differed dramatically from those in blood. In pediatric AIDS, reduction of CD4/CD8 ratio was much more pronounced in BALF than in peripheral blood (0.15 +/- 0.04 vs. 0.43 +/- 0.11). This difference was due to selective depletion of BALF CD4+ lymphocytes, rather than to a great influx of CD8+ cells into the lung. In childhood TB, the CD4/CD8 ratio in BALF also was significantly decreased, despite its elevation in blood (1.02 +/- 0.26 vs. 1.96 +/- 0.32). The results show that (1) examination of peripheral blood lymphocytes does not reflect the kind and extent of changes observed in the distribution of pulmonary lymphocyte subsets, and (2) the profound decrease of the CD4/CD8 ratios in BALF of children with AIDS or TB is due to decreased percentages and absolute numbers of BALF CD4+ lymphocytes. The data suggest that analysis of BALF provides a more accurate evaluation of the patient pulmonary immune status than monitoring peripheral blood.
Pulmonary cells and fluid obtained by bronchoalveolar lavage (BAL) from 19 pediatric acquired immunodeficiency syndrome (AIDS) patients with pneumonia were examined for markers of human immunodeficiency virus (HIV-1) infection. The HIV-1 DNA was detected in BAL cells by polymerase chain reaction (PCR) in 14 of 15 patients (93.3 percent). Immunostaining of cytocentrifuged cell preparations of six specimens revealed that HIV-1 antigen was associated with from five percent to 95 percent of the alveolar macrophages. Analysis of the 22 cell-free BAL fluids by enzyme immunoassay (EIA) showed that samples from three patients (15.8 percent) contained HIV-1 p24 antigen. One sample, with a dilution factor of 15.1 relative to serum, contained a markedly elevated antigen concentration (106 pg per ml) compared to the serum concentration (41.6 pg per ml). Antibodies to HIV-1 were present in the BAL fluids of six patients (31.6 percent) at levels detectable by EIA. By Western blot analysis, three samples yielded more intense gp120 bands compared to bands observed with matched serum samples. Our results suggest that HIV-1 and antibodies to this virus are frequently present in the lungs of children with AIDS and that the serum antigen and antibody profile of some patients does not reflect local pulmonary levels.
The role of local immunity in relation to the frequent and heterogeneous pulmonary manifestations of HIV-1 infection in children is poorly understood. In order to examine lung immunity in pediatric AIDS patients, the cellular composition, immunoglobulin, and immune complex (IC) levels were evaluated in 23 samples of bronchoalveolar lavage (BAL) fluid and peripheral blood from 19 pediatric AIDS patients with acute pulmonary pathology. The patients were of two age groups: 4.0-21.5 months (N = 9) and 2.3-13.1 years (N = 10). In BAL, lymphocytes were elevated in 25-45% of samples, and neutrophils were elevated in 27-33%; BAL macrophages varied in percentage (28-99%) but had normal morphology. The blood differentials of pediatric AIDS patients undergoing BAL did not show significant differences when compared with a group of pediatric patients with tuberculosis, but leuko- and neutropenia was noted when compared with pediatric patients with pneumonia and no HIV disease. Of the immunoglobulins measured (IgG, IgM, IgA) only IgG was detectable in unconcentrated BAL fluid (1-37 mg/dl, equivalent to 12-630 mg/dl in the epithelial lining fluid after correction using urea as a marker of dilution). All patients were hypergammaglobulinemic and 83% had high levels of circulating IC (2-40 muEq/ml). Six BAL specimens (26%) also contained IC. The estimated level of IC in lung epithelial lining fluid (after correcting for dilution) was up to fivefold higher than IC concentration in corresponding sera. Specific antibodies to HIV-1 were demonstrated in 35% of the BAL samples by ELISA and in 65% by Western blotting.(ABSTRACT TRUNCATED AT 250 WORDS)
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Randomized, double blind, placebo controlled clinical studies aimed at evaluating the efficiency of nedocromil sodium (Tilade) in the form of metered dosimeter aerosol. Studies involved patients with moderate chronic bronchial asthma controlled with beta 2-agonists and theophylline in the form of sustained release preparations. Forty patients completed the studies. All patients were examined clinically (staging of the symptoms and doses of drugs) and spirometrically prior to and after 4 and 8 weeks of the treatment with nedocromil sodium. Statistically significant clinical improvement and spirometric improvement as well in patients treated with nedocromil sodium were noted. It may be concluded that nedocromil sodium is effective and well tolerated adjuvant therapy in the bronchial asthma.